同步12导联动态心电图联合平板运动试验对冠心病心肌缺血的诊断价值  

Diagnostic Value of Simultaneous 12-lead Holter Electrocardiogram Combined with Treadmill Exercise Test for Myocardial Ischemia in Coronary Heart Disease

作　　者：王如强 陈晓 张冲冲 贾耀勤[1] WANG Ru-qiang;CHEN Xiao;ZHANG Chong-chong;JIA Yao-qin(Department of Electrocardiography,the Second People's Hospital of Zhengzhou,Zhengzhou 450015,China)

机构地区：[1]郑州市第二人民医院心电图科,郑州450015

出　　处：《四川解剖学杂志》2023年第3期74-76,共3页Sichuan Journal of Anatomy

摘　　要：目的:同步12导联动态心电图联合平板运动试验对冠心病心肌缺血的诊断价值.方法:选择2019年6月至2022年10月本院收治的216例疑似冠心病心肌缺血患者作为研究对象.患者均接受冠脉造影、同步12导联动态心电图、平板运动试验检查;以冠脉造影结果为诊断冠心病心肌缺血的金标准;比较其余二者单一检查和联合检查的诊断价值及单、多支冠脉病变的检出率.结果:冠脉造影检查真阳性118例,真阴性98例;同步12导联动态心电图检查真阳性63例,真阴性80例;平板运动试验检查真阳性73例,真阴性82例;两者联合检查真阳性95例,真阴性69例.联合检查特异性、符合率、敏感性以及阳性预测率分别为75.82%、75.93%、76.00%、81.20%.联合检查单、多支冠脉病变的检出率以及总诊断率均高于单一检查(P<0.05).结论:将同步12导联动态心电图联合平板运动试验的检查方法应用于冠心病患者心肌缺血诊断中,可有效提高诊断的准确性,相对单一检查安全性较高,有较好的诊断效果.Objective:To evaluate the diagnostic value of simultaneous 12-lead dynamic electrocardiogram combined with treadmill exercise test for myocardial ischemia in coronary heart disease.Methods:A total of 216 patients with myocardial ischemia suspected of coronary heart disease who received coronary angiography in our hospital from June 2019 to October 2022 were selected as subjects.All patients underwent coronary angiography,simultaneous 12-lead dynamic electrocardiogram and treadmill exercise test,and the results of coronary angiography were used as the gold standard for the diagnosis of myocardial ischemia in coronary heart disease.The diagnostic value of single and combined examinations and the detection rate of single and multi-vessel coronary artery lesions were compared.Results:There were 118 true positive cases and 98 true negative cases;synchronous 12-lead ambulatory electrocardiogram examination showed 63 true positive cases and 80 true negative cases;the treadmill exercise test showed true positive in 73 cases and true negative in 82 cases;and there were 95 cases of true positives and 69 cases of true negatives in the combined examination of the two.The specificity,coincidence rate,sensitivity and positive prediction rate were 75.82%,75.93%,76.00%and 81.20%,respectively.The detection rate and total diagnosis rate of combined examination and multi-vessel coronary artery disease were higher than those of single examination(P<0.05).Conclusion:Applying the examination method of synchronous 12-lead dynamic electrocardiogram combined with treadmill exercise test to the diagnosis of myocardial ischemia in patients with coronary heart disease can effectively improve the accuracy of diagnosis,which has higher safety and better diagnostic effect than single examination.

关 键 词：同步12导联动态心电图 平板运动试验 冠心病 心肌缺血 

分 类 号：R541.4[医药卫生—心血管疾病]